- Prime Therapeutics (Indianapolis, IN)
- …every decision we make. **Job Posting Title** Senior Project Solution Manager ( Utilization Management ) - Remote **Job Description Summary** Responsible ... and summarizing progress of projects. Prepares reports for upper management regarding status of project. Familiar with a variety...+ For clinical related roles, clinical licensure (eg, LPN, RN , LCSW, LMSW) is preferred. + 7+ years of… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management , RN - IN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of ... Inc. at https://www.mdwise.org/ **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- Elevance Health (Indianapolis, IN)
- **Managed Care Coordinator Clinician Non RN ** **Location:** Remote , within 50 miles of an Elevance location **Shift:** 10:30 am - 7 pm CST, with the possibility ... Saturday shift from 8 am - 2 pm CST. The **Managed Care Coordinator Clinician Non- RN ** is responsible for working under the direction/supervision of an RN , with… more
- Elevance Health (Indianapolis, IN)
- …and Experiences:** + Home health experience preferred. + 1 year of Utilization Management experience preferred. + Multi-State/Compact Nursing License strongly ... **Wound Care UM RN ** **Location:** Remote , within 50 miles...wound care. + Promotes healing and decrease home care utilization . + Responsible for certification determinations and sending written… more
- Marriott (Indianapolis, IN)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... **Claims Services** + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- International Medical Group (Indianapolis, IN)
- …or tasks as assigned. QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing direct ... creating the best experience for travelers. JOB DETAILS + RN License -- Must have an active RN...management cases by diagnosis, dollar amount and/or high utilization of medical services and refer those identified for… more
- Centene Corporation (Indianapolis, IN)
- … or data reporting and evaluation. Experience working in managed care, utilization management , case management , or quality improvement preferred. ... provider and member satisfaction + Serve as a resource and liaison on utilization , quality improvement, and case management activities + Partner with various… more
- Elevance Health (Indianapolis, IN)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- Elevance Health (Indianapolis, IN)
- ** Nurse Audit Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- Centene Corporation (Indianapolis, IN)
- …or BCBA. ABA or BCBA highly preferred. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Elevance Health (Indianapolis, IN)
- **Senior Investigator (Investigator Sr)** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one ... of business and/or state. + May interface internally with Senior level management and legal department throughout investigative process. + May assist in training… more
- Elevance Health (Indianapolis, IN)
- …+ Licensure is a requirement for this position. + Previous experience in case management / utilization management with a broad range of experience with complex ... will be licensed and domiciled in Indiana. This is hybrid/ remote role where the hired candidate may be asked...equivalent background. + Current active unrestricted license, such as RN , LCSW, LMHC, LPC, LMFT to practice as a… more